HTERC基因在宫颈上皮内瘤样病变治疗后监测的相关性研究

Related research of HTERC gene in cervical intraepithelial neapalsia after the treatment

目的探讨人端粒酶RNA基因(human telomerase RNA component,HTERC)在宫颈上皮内瘤样病变(cervical intraepithelial neapalsia,CIN)治疗后病情监测中的价值。方法选取83例CIN患者,治疗前均行宫颈脱落细胞学检查(thin prep cytologic test,TCT)、高危型人乳头瘤病毒(high risk-human papillomavirus,HR-HPV)、阴道镜活检及HTERC检测。于治疗后6个月及1年随访时再次行上述检查。结果 1随宫颈病变程度增加,HTERC基因阳性表达率增加,且差异有统计学意义;2治疗后半年复查发现细胞学异常程度、高危型HPV阳性率及HTERC基因检测阳性率较治疗前均有显著减少,差异具有统计学意义;但HTERC阳性患者较HTERC阴性患者治疗后相比,宫颈病变转归差异无统计学意义;3几种检测方法比较,宫颈脱落细胞学检查对于宫颈病变的阳性预测值相对较强,HR-HPV检查对于宫颈病变预测的灵敏度和阴性预测值相对较高,HTERC检测对于宫颈病变预测特异度最高。结论在患者有HR-HPV持续感染、特别是宫颈出现CIN改变时,可行HTERC基因检测辅助预测病变的发展情况。

Objective To explore the monitoring value of human telomerase RNA component（ HTERC） gene in cervical intraepithelial neapalsia（ CIN） after the treatment. Methods Totally eight-three patients confirmed as cervical intraepithelial neapalsia were chosen.Those patients were examined with thin prep cytologic test（ TCT）,high risk-human papillomavirus（ HR-HPV） detection,multi-point biopsy and HTERC gene preoperative. Then we examined TCT,HPV,HTERC gene and colposcopy biopsy at the time of 6 months and 1year follow-up. Results ① With the histological lesion degree increasing,HTERC gene positive expression rate increased,and the increased difference is statistically significant. ② Half year after the treatment,we discovered that the cytology,high-risk type HPV positive rate and positive HTERC gene detection rate（ HTERC gene positive rate was 0% after the treatment）,were significantly reduced compared with preoperative,and it suggested that the surgery could effectively reduce the degree of cervical lesions,high-risk type HPV positive rate and positive rate of HTERC gene. ③ Comparing those tests,we found that the TCT had the highest positive predictive value,the HR-HPV had the highest sensitivity and negative predictive value,and the HTERC had the highest specificity. Conclusion When patients have HR-HPV infection,and especially have the CIN,it will help predict the direction of development of the disease with the HTERC gene detects added.